Robotic Cleft Palate Repair Using Novel 3 mm Wristed Tools

Cleft palate repair is a technically challenging procedure requiring delicate tissue handling and precision. In a pre- vious study, [1] our group demonstrated the advantages of using a surgical robot over traditional instruments in cleft palate repair. The 8 mm wrist was considered superior due to its more space-efficient articulation. However, the 8 mm diameter instruments are too large for the infant oral cavity. We have thus developed a novel 3 mm diameter pin-jointed wrist with a unique cable-guide channel and CAM mechanism to ensure more compact wrist articulation with a lower profile for this workspace [2]. Additionally, the tool profiles were optimized for infant cleft palate repair and trans-oral robotic surgery (TORS). The following study investigates the use of these 3 mm tools to perform knot-tying within the confines of the infant oral cavity using a high-fidelity cleft palate simulator. Their performance was compared to the 8 mm da Vinci EndoWrist instruments to determine the advantages of using these smaller tools.